<!-- 情報誌のご案内確認画面 -->
<!-- InstanceEndEditable -->
	<div id="main">
		<!-- InstanceBeginEditable name="main" -->
		<h1 id="specialTitle">{$contentsTitle}</h1>

		<!-- siteContents -->
		<div id="siteContents">
			<h1>送付申し込みフォーム</h1>
			<!-- contentsBlock -->
			<div id="contentsBlock">
				<!-- contents -->
				<div id="contents">
					<div id="sendMagazineForm">
						<div class="h2CmBlock01">
							<h2><span>お届け先情報の確認</span></h2>
						</div>
						<p class="tableLead">下記の内容で送信します。内容をご確認の上、「申し込む」ボタンを押してください。 </p>
						<table id="inqAllTable">
				        	<tr>
				        		<th>送付希望情報誌</th>
					        	<td>{$SoufuKibouJyouhoushiText}</td>
					   		</tr>
				        	<tr>
				        		<th>お名前</th>
					        	<td>{$NameSei}　{$NameMei}</td>
					   		</tr>
				        	<tr>
				        		<th>フリガナ</span></th>
					        	<td>{$KanaSei}　{$KanaMei}</td>
					   		</tr>
							<tr>
								<th>年齢</th>
								<td>{$AgeNm}</td>
							</tr>
							<tr>
								<th>性別</th>
								<td>{$SexNm}</td>
							</tr>
							<tr>
								<th>結婚</th>
								<td>{$MrrgNm}</td>
							</tr>
							<tr>
								<th>ご職業</th>
								<td>{$JobNm}</td>
							</tr>
							<tr>
								<th>ご住所</th>
								<td>
									<p>〒&nbsp;{$Zip1}&nbsp;-&nbsp;{$Zip2}</p>
									<p>{$PrefName}</p>
									<p>{$Address}</p>
								</td>
							</tr>
							<tr>
								<th>電話番号</th>
								<td>{$Tel}</td>
							</tr>
							<tr>
								<th>FAX</th>
								<td>{$Fax}</td>
							</tr>

							<!-- E-mail -->
							<tr>
						       	<th>メールアドレス</th>
				        		<td>{$Mail}</td>
				       		</tr>
							<!-- ｸﾚｰﾑ対象 -->
							<!-- ご意見･ご感想 -->
							<tr>
								<th>ご意見・ご感想</th>
								<td>{$Comment}</td>
		       				</tr>
				       	</table>
						<div class="h2CmBlock02">
							<h2><span>アンケート</span></h2>
						</div>
						<dl class="anquete">
							<dt>Q1：お引越しの理由をお選びください。</dt>
							<dd>{$HikkoshiRiyuuText}</dd>
							<dt>Q2：今まで情報誌「アパマンショップ」を購入したことがありますか？</dt>
							<dd>{$KounyuuKeikenText}</dd>
							<dt>Q3：情報誌「アパマンショップ」を知ったきっかけは？</dt>
							<dd>{$KikkakeText}</dd>
							<dt>Q4：情報誌「アパマンショップ」以外の賃貸情報誌をご覧になりましたか？</dt>
							<dd>{$SonotaZassiText}</dd>
							<dt>Q5：お部屋探しの際に重視する項目をお選びください。<span>（複数回答可）</span></dt>
							<dd>{$JyuushiKoumokuText}</dd>
							<dt>Q6：情報誌「アパマンショップ」に掲載して欲しい物件の特集記事をお選びください。<span>（複数回答可）</span></dt>
							<dd>{$NeedTokushuuText}</dd>
						</dl>
						<!-- confirmFootTxt -->
						<div id="confirmFootTxt">
								<ul>
									<li>
										<a href="javascript:void(0);">
										<img src="/images/inquiry/hp/form/btn_rewrite.jpg" alt="修正する" onclick="javascript:magazineBackToEntry(); return false;" width="158" height="35" class="rollImg" />
										</a>
									</li>
									<li class="last">
										<a href="javascript:void(0);">
										<input name="Submit" type="image" class="rollImg" id="Submit" src="/images/inquiry/hp/form/btn_subscription.jpg" width="158" height="35" alt="申し込む" onclick="javascript:magazineCnfSubmit(); return false;" />
										</a>
									</li>
								</ul>
						</div>
					</div>
					<!-- /inqAllForm -->
				<!-- /contents -->
				</div>
				<!-- side -->
				<div id="side">
					<!-- sideNavi -->
					<div id="sideNavi">
						<ul class="first">
							<li><p><a href="{$baseurl}jyohoshi/shoukai.html">情報誌のご案内</a></p></li>
							<li><p><a href="{$baseurl}jyohoshi/katsuyou.html">情報誌120％活用法</a></p></li>
							<li><p><a href="{$baseurl}jyohoshi/mobile.html">モバイルで便利に</a></p></li>
							<li><p><a href="{$baseurl}jyohoshi/mikata.html">新生活の強い味方</a></p></li>
							<li class="current"><p><a href="{$sslurl}inquiry/magazineentry/">情報誌のお問い合わせ</a></p></li>
						</ul>
					</div>
					<!-- /sideNavi -->
				</div>
				<!-- /side -->
			</div>
			<!-- /contentsBlock -->
		</div>
		<!-- /siteContents -->

		<!-- InstanceEndEditable -->
	</div>
<input type="hidden" id="JyuushiKoumoku1" name="JyuushiKoumoku1" value="{$JyuushiKoumoku1}" />
<input type="hidden" id="JyuushiKoumoku2" name="JyuushiKoumoku2" value="{$JyuushiKoumoku2}" />
<input type="hidden" id="JyuushiKoumoku3" name="JyuushiKoumoku3" value="{$JyuushiKoumoku3}" />
<input type="hidden" id="JyuushiKoumoku4" name="JyuushiKoumoku4" value="{$JyuushiKoumoku4}" />
<input type="hidden" id="JyuushiKoumoku5" name="JyuushiKoumoku5" value="{$JyuushiKoumoku5}" />
<input type="hidden" id="JyuushiKoumoku6" name="JyuushiKoumoku6" value="{$JyuushiKoumoku6}" />
<input type="hidden" id="JyuushiKoumoku7" name="JyuushiKoumoku7" value="{$JyuushiKoumoku7}" />
<input type="hidden" id="JyuushiKoumoku8" name="JyuushiKoumoku8" value="{$JyuushiKoumoku8}" />
<input type="hidden" id="NeedTokushuu1" name="NeedTokushuu1" value="{$NeedTokushuu1}" />
<input type="hidden" id="NeedTokushuu2" name="NeedTokushuu2" value="{$NeedTokushuu2}" />
<input type="hidden" id="NeedTokushuu3" name="NeedTokushuu3" value="{$NeedTokushuu3}" />
<input type="hidden" id="NeedTokushuu4" name="NeedTokushuu4" value="{$NeedTokushuu4}" />
<input type="hidden" id="NeedTokushuu5" name="NeedTokushuu5" value="{$NeedTokushuu5}" />
<input type="hidden" id="NeedTokushuu6" name="NeedTokushuu6" value="{$NeedTokushuu6}" />
<!-- 共通パラメータここから -->
<input type="hidden" id="CntctWayFax" name="CntctWayFax" value="{$CntctWayFax}" />
<input type="hidden" id="CntctWayMail" name="CntctWayMail" value="{$CntctWayMail}" />
<input type="hidden" id="CntctWayTel" name="CntctWayTel" value="{$CntctWayTel}" />
<input type="hidden" id="CntctWayCd" name="CntctWayCd" value="{$CntctWayCd}" />
<input type="hidden" id="CntctWayStr" name="CntctWayStr" value="{$CntctWayStr}" />
<input type="hidden" id="Fax" name="Fax" value="{$Fax}" />
<input type="hidden" id="Inquiry1" name="Inquiry1" value="{$Inquiry1}" />
<input type="hidden" id="Inquiry2" name="Inquiry2" value="{$Inquiry2}" />
<input type="hidden" id="Inquiry3" name="Inquiry3" value="{$Inquiry3}" />
<input type="hidden" id="Inquiry4" name="Inquiry4" value="{$Inquiry4}" />
<input type="hidden" id="Inquiry5" name="Inquiry5" value="{$Inquiry5}" />
<input type="hidden" id="Mail" name="Mail" value="{$Mail}" />
<input type="hidden" id="MailMgznFlg" name="MailMgznFlg" value="{$MailMgznFlg}" />
<input type="hidden" id="Name" name="Name" value="{$Name}" />
<input type="hidden" id="NameMei" name="NameMei" value="{$NameMei}" />
<input type="hidden" id="NameSei" name="NameSei" value="{$NameSei}" />
<input type="hidden" id="KanaSei" name="KanaSei" value="{$KanaSei}" />
<input type="hidden" id="KanaMei" name="KanaMei" value="{$KanaMei}" />
<input type="hidden" id="NeedTimeKbn" name="NeedTimeKbn" value="{$NeedTimeKbn}" />
<input type="hidden" id="PlaceKbn" name="PlaceKbn" value="{$PlaceKbn}" />
<input type="hidden" id="ShopCd" name="ShopCd" value="{$ShopCd}" />
<input type="hidden" id="Tel" name="Tel" value="{$Tel}" />
<input type="hidden" id="UseKbn" name="UseKbn" value="{$UseKbn}" />
<input type="hidden" id="SrhKbn" name="SrhKbn" value="{$SrhKbn}" />
<input type="hidden" id="OemCd" name="OemCd" value="{$OemCd}" />
<input type="hidden" id="Url" name="Url" value="{$Url}" />
<input type="hidden" id="Company" name="Company" value="{$Company}" />
<input type="hidden" id="CtgryCd" name="CtgryCd" value="{$CtgryCd}" />
<input type="hidden" id="ClaimTgtKbn" name="ClaimTgtKbn" value="{$ClaimTgtKbn}" />
<input type="hidden" id="Mrrg" name="Mrrg" value="{$Mrrg}" />
<input type="hidden" id="MrrgNm" name="MrrgNm" value="{$MrrgNm}" />
<input type="hidden" id="BuyExp" name="BuyExp" value="{$BuyExp}" />
<input type="hidden" id="BuyExpNm" name="BuyExpNm" value="{$BuyExpNm}" />
<input type="hidden" id="Comment" name="Comment" value="{$Comment}" />
<input type="hidden" id="Other" name="Other" value="{$Other}" />
<input type="hidden" id="SiteKbn" name="SiteKbn" value="{$SiteKbn}" />
<input type="hidden" id="Address" name="Address" value="{$Address}" />
<input type="hidden" id="Address1" name="Address1" value="{$Address1}" />
<input type="hidden" id="Address2" name="Address2" value="{$Address2}" />
<input type="hidden" id="JobKbn" name="JobKbn" value="{$JobKbn}" />
<input type="hidden" id="JobNm" name="JobNm" value="{$JobNm}" />
<input type="hidden" id="Sex" name="Sex" value="{$Sex}" />
<input type="hidden" id="SexNm" name="SexNm" value="{$SexNm}" />
<input type="hidden" id="Charge" name="Charge" value="{$Charge}" />
<input type="hidden" id="ChargeNm" name="ChargeNm" value="{$ChargeNm}" />
<input type="hidden" id="ChargeNmKana" name="ChargeNmKana" value="{$ChargeNmKana}" />
<input type="hidden" id="TenpoNm" name="TenpoNm" value="{$TenpoNm}" />
<input type="hidden" id="TenpoMail" name="TenpoMail" value="{$TenpoMail}" />
<input type="hidden" id="PrefCd" name="PrefCd" value="{$PrefCd}" />
<input type="hidden" id="PrefName" name="PrefName" value="{$PrefName}" />
<input type="hidden" id="AgeKbn" name="AgeKbn" value="{$AgeKbn}" />
<input type="hidden" id="AgeNm" name="AgeNm" value="{$AgeNm}" />
<input type="hidden" id="Busho" name="Busho" value="{$Busho}" />
<input type="hidden" id="BukkenCd" name="BukkenCd" value="{$BukkenCd}" />
<input type="hidden" id="Matrix" name="Matrix" value="{$Matrix}" />
<input type="hidden" id="Yakushoku" name="Yakushoku" value="{$Yakushoku}" />
<input type="hidden" id="Zip" name="Zip" value="{$Zip}" />
<input type="hidden" id="Zip1" name="Zip1" value="{$Zip1}" />
<input type="hidden" id="Zip2" name="Zip2" value="{$Zip2}" />
<input type="hidden" id="TargetKbn" name="TargetKbn" value="{$TargetKbn}" />
<input type="hidden" id="TargetNm" name="TargetNm" value="{$TargetNm}" />
<input type="hidden" id="ComId" name="ComId" value="{$ComId}" />
<input type="hidden" id="HikkoshiRiyuuText" name="HikkoshiRiyuuText" value="{$HikkoshiRiyuuText}" />
<input type="hidden" id="HikkoshiRiyuu" name="HikkoshiRiyuu" value="{$HikkoshiRiyuu}" />
<input type="hidden" id="HikkoshiRiyuuSonota" name="HikkoshiRiyuuSonota" value="{$HikkoshiRiyuuSonota}" />
<input type="hidden" id="NeedTokushuuText" name="NeedTokushuuText" value="{$NeedTokushuuText}" />
<input type="hidden" id="NeedTokushuu" name="NeedTokushuu" value="{$NeedTokushuu}" />
<input type="hidden" id="NeedTokushuuSonota" name="NeedTokushuuSonota" value="{$NeedTokushuuSonota}" />
<input type="hidden" id="KounyuuKeikenText" name="KounyuuKeikenText" value="{$KounyuuKeikenText}" />
<input type="hidden" id="KounyuuKeiken" name="KounyuuKeiken" value="{$KounyuuKeiken}" />
<input type="hidden" id="SonotaZassiText" name="SonotaZassiText" value="{$SonotaZassiText}" />
<input type="hidden" id="SonotaZassi" name="SonotaZassi" value="{$SonotaZassi}" />
<input type="hidden" id="SonotaZassiName" name="SonotaZassiName" value="{$SonotaZassiName}" />
<input type="hidden" id="SoufuKibouJyouhoushiText" name="SoufuKibouJyouhoushiText" value="{$SoufuKibouJyouhoushiText}" />
<input type="hidden" id="SoufuKibouJyouhoushi" name="SoufuKibouJyouhoushi" value="{$SoufuKibouJyouhoushi}" />
<input type="hidden" id="KikkakeText" name="KikkakeText" value="{$KikkakeText}" />
<input type="hidden" id="Kikkake" name="Kikkake" value="{$Kikkake}" />
<input type="hidden" id="KikkakeSonota" name="KikkakeSonota" value="{$KikkakeSonota}" />
<input type="hidden" id="JyuushiKoumokuText" name="JyuushiKoumokuText" value="{$JyuushiKoumokuText}" />
<input type="hidden" id="JyuushiKoumoku" name="JyuushiKoumoku" value="{$JyuushiKoumoku}" />
<input type="hidden" id="JyuushiKoumokuSonota" name="JyuushiKoumokuSonota" value="{$JyuushiKoumokuSonota}" />
<input type="hidden" id="FavFlg" name="FavFlg" value="{$FavFlg}" />
<input type="hidden" id="Did" name="Did" value="{$Did}" />
<input type="hidden" id="Sid" name="Sid" value="{$Sid}" />
<input type="hidden" id="UAKbn" name="UAKbn" value="{$UAKbn}" />
<input type="hidden" id="CampaignLocationFlg" name="CampaignLocationFlg" value="{$CampaignLocationFlg}" />
<input type="hidden" id="TimeStr" name="TimeStr" value="{$TimeStr}" />
<!-- 共通パラメータここまで -->